| Organization Name: | JOSEPH PETER FODERO MD PA |
| NPI Number: | 1093071276 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH PETER FODERO (PRESIDENT) |
| Mailing Address: | 220 Ridgedale Ave Florham Park |
| State: | NJ US |
| Postal Code: | 079321361 |
| Phone Number: | 9732956565 |
| Fax Number: | 9732956567 |
| NPI Enumeration Date: | 04/02/2012 |
| NPI Last Update Date: | 04/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | MA69380 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |